Provider Demographics
NPI:1033468798
Name:TOMSAH, MONIA A (RPH)
Entity Type:Individual
Prefix:
First Name:MONIA
Middle Name:A
Last Name:TOMSAH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 S MILL AVE
Mailing Address - Street 2:#126
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-6801
Mailing Address - Country:US
Mailing Address - Phone:602-341-2862
Mailing Address - Fax:
Practice Address - Street 1:2250 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-6947
Practice Address - Country:US
Practice Address - Phone:602-305-4421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-09
Last Update Date:2012-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist